I have suffered from vulvar pain for five years. My partner of seven years is understanding, but we get frustrated as it is often easier to avoid sex. We have talked about marriage, but we want to get this problem sorted out first. What can we do?

There are many erogenous zones, and the erotic imagination can create a fantastic, non-genital sexual experience, so perhaps you could reintroduce anything you enjoy that doesn't involve vulval touch. Consider asking your partner to attend a medical appointment with you, so he or she can be fully educated about your condition.

Carefully consider your pain. Are there certain times of the day, positions, or kinds of touch that cause you less or more discomfort? You and your partner need to understand those things. Plan a new approach – there may be solutions such as using ice-packs, or switching to more comfortable positions, and some gynaecologists recommend topical anaesthetics. In consultation with your doctor, decide what is possible and what is off-limits so you feel in control.

Eventually, you may trust your partner to try certain types of vulvar touch, under your careful guidance. Use a water-based lubricant. Become a team in searching for a helpful vulvar pain specialist, in sharing feelings about this challenge, and finding ways to remain physically intimate without exposing you to further pain.

• Pamela Stephenson Connolly is a clinical psychologist and psychotherapist who specialises in treating sexual disorders.